Approximately 9 of every 10,000 people in the United States are diagnosed with appendicitis every year. Patients often present with abdominal pain. The pain can be localized to the belly button and move to the right lower abdomen. However, often times patients present with just right-sided pain in the lower abdomen. Patients often complain of nausea, poor appetite, and vomiting. Fever is a common complaint as well as the disease process progresses.
Traditionally, appendicitis was based on clinical factors – the patient’s symptoms and physical exam. However, most people today present with appendicitis to the emergency room where routine blood work usually shows an increased white blood cell count (WBC), which is a measure of infection. Often a CT scan or an ultrasound is performed as well to help identify the specific cause of the patient’s abdominal pain.
The gold standard of treatment remains surgical removal of the appendix. This is usually performed using laparoscopic equipment using a thin, long camera and two other small incisions, each less than an inch in size. Some patients require an open procedure if the inflammation is too severe to safely remove the appendix. Sometimes, if appendicitis is found very early it is treated with antibiotics. However, some of these patients will return with repeat symptoms requiring surgery.
If appendicitis is discovered before the appendix bursts (perforation) these patients can often go home 24 hours after surgery as long as they are free of fever and pain is improved. Patients should not lift anything more than 5 lbs in the first 1-2 weeks and try not to over exert themselves. Most patients can drive and go back to work within a week as long as they are no longer taking oral pain medications and remain free of fever.
Buckius et al., Changing Epidemiology of Acute Appendicitis in the United States: Study Period 1993–2008, Journal of Surgical Research, 2012.